Individual
BASSAM BAROUDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4215 15TH ST, GULFPORT, MS 39501-2523
(228) 863-5211
(228) 863-4101
Mailing address
PO BOX 1810, GULFPORT, MS 39502-1810
(228) 863-5211
(228) 575-2917
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
15167
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120353
—
MS
Enumeration date
07/02/2006
Last updated
10/19/2023
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